Penance Has a Sound
by The Assassin's Pen
Summary: Adam's body took to augmentation so well nobody thought the energy drain could eventually burn out his heart. One shot set in part between the two games and in the middle of the extended universe I've written. Slight Malik/Adam as well as father/son type relationship between Adam and David. T for medical slash surgical description.


Began Deus Ex Mankind Divided today and a new little detail about Adam caught my attention. In the first game during the surgery it's apparent (and symbolic of course) that one of the things left organic is his heart. There's all kinds of tech surrounding it, but he keeps his flesh heart. In DXMD, (small spoiler) Adam has a mechanical heart. This bugged me at first but then I was thinking about the symbolism of accepting what you've become in this game so a mechanical heart makes sense. I got this idea and had to type it out real quick.

If you haven't read my other stories you may be slightly perplexed in this one but the short version is that I write Adam and Malik as a very slow burn romance. They eventually end up together but for a while they are just very close, very comfortable friends. In my other story Ransom for Justice Adam is captured and tortured in revenge for Malik exposing Lee at the Hive as a murderer.

* * *

The first signs came quietly, and because he had no flesh arms to tell him something was wrong it was too late by the time they noticed.

"Adam?" Faridah exclaimed, hand on his shoulder, concern in her eyes as she knelt with him. He was bent over in the sand, clutching at his chest as he tried to breathe.

Two hours ago they'd woken up in a Nile side hotel in Egypt. They had breakfast together at a cafe and Adam took his briefing while Malik made fun of the man on the screen just out of video range. Adam spent the whole time trying not to laugh. He'd been fine. The last six missions he'd been fine. They'd decided to go walking under the palms growing on the Nile bank because they had time to kill before the mission began at dusk, and that was when Adam had started looking vaguely pale.

"Is it the heat?" Malik asked, pressing the back of her hand to his forehead. Adam was wearing a t shirt and shorts, but with far less skin than most people had for temperature control sometimes getting too warm was an issue. His augments channeled heat and weren't great at expelling it, especially not under the Cairo sun. Black was bad that way.

He shook his head and tried to breathe enough to answer, but he couldn't. He just couldn't and his vision was blurring. He was sweating and underneath Faridah's hand she felt him tremble. "Okay, okay we're getting you out of here," Faridah said, doing the only thing she could think of. She got him down by the Nile and pulled him into the water.

The cold shocked him immediately, but even though it cleared his head his chest still hurt and breathing was still far too difficult. He clutched on Faridah in a blind panic hard enough that she'd have bruises later, but neither one of them had the presence of mind to care at the moment. For a long time they stood waist deep in the Nile, the current tugging at them and the chatter of concerned voices around starting to gather on the bank.

"نوبة قلبية" someone said, and Faridah felt a spear of anguish as her mind translated. _Heart attack_ , she realized, and even though the pit in her stomach wanted her to deny it the ice filling that pit wouldn't let her.

"Okay Adam, I need you to try and relax," she said, knowing that this was very different from a panic attack but that the panic it was causing would only make the damage worse. She freed herself from his grip and hugged him tightly, hiding his head in the crook of her shoulder. "I know it feels like your chest is tight, but it'll pass you need to relax."

Her voice was steady but her heart was not. She could feel Adam's chest hitch against her, feel the tremble in his back muscles as they spasmed from pain. As she curled her hand tightly in his collar and felt the sweat on the back of his neck she squeezed her eyes shut and prayed desperately that no matter how tired it was or how much damage the attack caused that she wouldn't feel Adam's heart stop beating against her.

A few more moments of agony passed where Adam struggled to breathe, but he didn't fight her. He clung to her and eventually she felt the tension go out of him. His knees buckled and she was afraid for a moment that he'd lost consciousness, but he managed to lever himself back up and stand.

"Come on," Faridah said, her voice unsteady. A few people had waded in to help, and she felt a great swell of gratitude for them. Most people if they saw an augmented person in distress would turn tail and run, assuming that they were suffering some kind of flashback to the aug incident. The three people who'd come into the river to steady Adam and help them both out hadn't hesitated.

"Adam, you cannot go out on the mission tonight," Faridah said, pacing around their room. "You almost collapsed. Someone in the crowd said heart attack and I'm kinda thinking they were right!"

Adam groaned and rubbed at his temples. "Faridah, I'm only in my thirties! I've been in good health my whole life. I've never had symptoms before-it was the heat!"

Faridah narrowed her eyes at him. "Adam, you still feel weak. You had chest pain. And even if the cigarettes and alcohol get filtered out of your system before they can do any damage you did smoke and drink before you were augmented."

"And I had a full physical after I was augmented! My heart was one of the only things _not_ damaged in the attack. Sarif left that part of me alone!"

Faridah pressed her lips together, folding her arms. Adam had gotten up, his shoulders tense with frustration, but he was breathing too hard. "Adam, please sit down," she said after a moment. Adam gave her a hard look. "I'm on your side," she pressed, and presently he relaxed and nodded.

"I know, I know that Malik," he sighed, rubbing his forehead and sitting back down. He rest his head in his hands. "I know."

She bit her lip, wishing she could fix things for him. She knew it must be horrible to constantly feel like your body was something you couldn't trust or didn't know. She sat on the arm of the chair and sighed, rubbing his back. "I think we should go back to Detroit and get you looked at."

"It doesn't make any sense," Adam mumbled, leaning his head against Faridah's thigh.

She swallowed, her mouth dry as she kept rubbing Adam's shoulders. "Actually, it makes a lot of sense," she said quietly. She felt cold remembering it, but the incident when Adam had been kidnapped and tortured because she'd messed with the wrong people would never leave her mind. She still had nightmares about it sometimes, and the guilt was a hard thing to chase away.

"Adam, I don't know how much you remember from the last time we were in Hengsha, but that sadistic doctor messed with your heart. Stopped it on purpose, put all kinds of crap into your body to get it beating again-" she buried her head in her hand. "Not to mention the strain your augs put on your body. I've read things like this, people get too many augs and the remaining flesh can't handle it. Your heart is still the power center of your body. It helps fuel the cells that power your prosthetics."

Adam's jaw tensed. He hadn't thought about that. And the pain in his chest, the fatigue—he couldn't ignore it. "Okay Malik," he nodded. "We'll go back to Detroit."

David was quiet for a long time. Adam hadn't gone to a doctor, he'd gone to Sarif himself. With his experimental augs and custom prosthesis Sarif and Doctor Vera were the only ones qualified to work on him. Both were in the private medical room at David's suite, and Adam was sitting in a chair beneath a light that was far too glaring for comfort. He felt exposed and exhausted, sticker sensors all over his chest relaying complex information to the screen taking up one whole wall. Faridah had offered to be there for support, but Adam felt too vulnerable as it was. He'd rather not add to it.

"There's definitely heart damage," Vera said quietly, removing leads and handing Adam his shirt. He gratefully put it back on, glancing between Vera and David. David had an expression he couldn't read and didn't like.

"What is it?" he asked bluntly.

David sighed, looking away from the screen where a detailed three dimensional rendering of Adam's heart was displayed. Great masses of the organ were lit up with red, and when a pulse cycle they'd recorded played back it was clear whole sections of Adam's heart had literally died. His exhaustion only reinforced the evidence.

"We didn't replace your heart when the initial surgery was done for a few reasons. One, you didn't need it. Most of your internal organs were intact and healing on their own, and frankly at the time augmented circulatory systems were just getting started. We can give you a better arm or leg, even an enhanced spinal column, but anyone with an augmented heart died in less than a year." He shook his head and folded his arms, turning to look at Adam apologetically. "We implanted bio sensors and hooked everything up to the sentinel health system but we left the organ alone otherwise."

Adam stood, his fingers clenching on the arm of the exam chair he'd just been sitting in. "But you knew this was going to happen," Adam said stiffly, barely restrained anger in his voice. "You knew that the experiments you ran on me would burn my heart out."

David's eyes went wide. "No! Adam, no I didn't. Everything about your biology pointed to an incredible resistance, even an attraction to augmentation. I admit I went too far with the surgery, but I was trying to improve your situation, not kill you!"

Adam folded his arms. "But."

Sarif seemed to deflate a little. "But...after the incident in China I was worried. They played havoc with your energy systems, intentionally stopped your heart with electrical damage." He shook his head and folded his arms. "And to tell the truth I was worried before that. At the time you showed exceptional adaptation to the augments. All your screens came back clean, and your cardiac health has _never_ been an issue. But then articles started cropping up about people with more than 38 percent of their bodies augmented. It was a strain. I theorized that the neuropozine was part of the problem, but I might have been wrong."

He nodded, feeling generally sick and tired. He was cold for once, and just wanted to go home and sleep. "So what are my options?"

"A transplant," Vera said. "That is your only option. The question is will you replace your damaged heart with an organic one or a mechanical one?"

"Considering I'd like to live more than another year I think my answer is pretty clear," Adam said, his temper short.

Vera's expression went sad and she nodded. "Adam, the only organic heart you'd be eligible for would be stolen."

Adam paled. "What?"

"The prejudice against augmented people has grown so far it prevents them from receiving organic parts legally. I can put you on a transplant list, but you'd die long before you'd become eligible for a new organ. Because of the medical reports that link organ damage to augmentations they've ruled against all augmented citizens. According to general medical opinion any aug with failing organs destroyed himself. It doesn't matter how the organ was damaged, if you're augmented they've already decided that the consequences are yours to deal with. Any heart you could get in time is stolen."

He had to sit down then, the tightness in his chest suddenly increasing. He felt short of breath, and the sensation of his heart trying to pound in his chest suddenly made him queasy.

"I have another option," David interjected quickly, his brow furrowed and his voice strained. "After reports of heart failure in extensively augmented individuals began cropping up I went back to the drawing board. I wasn't going to bring anything to the table but I kept working on it, just in case you ended up needing it."

"I don't have anything machined yet but I have a lot of designs done already. One of the biggest issues with augmented hearts in the past was the rejection rate. Wiring a metal heart into an organic system strained the systems to the breaking point, and the neuropiozine had to be taken in larger and larger doses until it just stopped working and the patient went into shock. There were other issues of course, but I think I've worked those out. The trade off is enormous energy drain, but that's something your enhanced system could handle."

Adam had to swallow bile when David started talking, had to remind himself that David was trying to help, that David wasn't looking at his dying body _again_ and thinking about all the exciting advancements his situation could uncover. "What advancements?" Adam ground out finally, working to calm himself. He was starting to feel light headed. "What exactly are you thinking about sticking inside me now?"

David put his hands up, trying to pacify. "I won't do a thing without your permission, I swear it, but I-" he swallowed, putting one hand on his hip and rubbing at his forehead with his other. "I won't stand here and watch you die. I didn't do it before and I won't again. This is strictly in your interest."

"Then show me what you've come up with," Adam said, not trusting himself to stand but looking David in the eye. "Be completely, totally, unreservedly honest with me this time."

Sarif nodded, his shoulders relaxing some. "Of course I will son," he said, hesitantly moving forward and kneeling in front of Adam. He placed a hand on his shoulder and Adam didn't shrug it off. "Of course I will."

"An augmented heart, huh?" Faridah said, sitting next to Adam on his couch back home.

"Not augmented," Adam said, lacing his fingers together. He was resting his elbows on his knees, watching the joints in his metal fingers and wondering how hollow he'd feel if they kept replacing pieces of him with metal. "Replaced. He'd take my heart out completely and replace it with a completely new, completely synthetic organ."

Malik felt sick at the prospect, but Adam's pale skin and weakened state worried her more. She had to take a deep breath to ask her next question and keep her voice from trembling. "Are you gonna do it?"

Adam's shoulders slumped and he felt the fight go out of him. "What choice do I have, Malik? What choice have I ever had? I don't want to die."

She hated the melancholy, the helplessness she heard in his voice but his admission released a huge burden from her shoulders. He'd been suicidal before. She couldn't stand the thought of seeing him go back to that dark place. "For what it's worth, I'll be there this time too." She leaned forward and kissed his forehead. "I'll be there the minute you wake up, spy boy."

In the weeks following Adam spent more and more time sleeping, his failing heart draining his energy beyond the ability to do much more than eat and shower. Malik was with him most of the time, watching movies with him, keeping his mind on other things while David worked feverishly to perfect and machine the heart Adam needed.

Finally, after simulations and days with minimal sleep David felt confident that he'd done everything he could possibly do. He hadn't trusted a team to work with him, had fashioned and designed every single coil and strand and overlay himself. Most synthetic hearts were a standard size for an adult. They didn't even take into account the differences between male and female usually, but determined to make this work David used the scans of Adam's natural organ and created a mechanical one to the exact same size and shape.

The day of Adam's surgery he slept in the surgical suite so they could monitor him and make sure he was stable enough to be cut open. The heart was in a glass tube filled with bio gel, suspended and heated to simulate the inside of a living chest cavity. Adam stared at it for a long time, trying to come to terms with what he was seeing. It was black and silver, the edges smooth and sleek, but like his prosthesis its gentle curves invoked something of the organic.

David had told him all the specs, and Adam listened, not understanding most of it. Synthetic valves coated with healing nanites for flexibility and internal wear repair. Bio-mesh laced with stem cell nanites would smooth the transition between his arteries and the heart. State of the art electrical wiring also re-enforced with healing nanites that would communicate directly with his nervous system, allowing his brain to continue directing blood flow without a hitch. Adrenaline receptors, minute capillaric feeds to supply the heart with energy and a new, crystal fiber pericardium would provide the final layer of defense.

He felt Malik's hand in his when they came in to put him under, but he had a hard time tearing his eyes away from the bundle of black and silver to look at her. He'd soon have to depend on that. He would be at its mercy. Having his limbs replaced and his brain glued back together was one thing. At least he'd been functioning on his own power.

"Hey," Malik caught his jaw gently and turned his head to look at her. She gave him a small smile and bent to kiss his lips. "I'll be here when you wake up."

Compared with replacing half of Adam's skeletal system the heart transplant went off without a hitch. He was placed on a heart lung machine and with a gentle, isolated current Vera commanded Adam's heart to rest. With a shuddering, final beat the exhausted organ lay still and she nodded, working with her team to cut it free with careful scalpel strokes. She lay the dead muscle reverently on a tray and covered it with a sterile cloth as David, scrubbed down and wearing surgical dress carried Adam's new heart over to the table and reached into the warm liquid to retrieve it.

With a determined breath and clenched jaw David handed his creation over, watching as the surgeons made quick work of nestling it into the cradle of glittering black and living red that Adam had become. They sutured the arteries into the aortic arch David had so carefully constructed, passing a sealing probe along each seam until there was no chance of a tear. When Vera inspected their work she nodded and the machine circulating Adam's blood was turned off. David personally removed the clamps keeping blood from reaching the new heart and set them aside, holding his breath as he waited for it to respond. Even before it began pumping he had the deep conviction that the heart _belonged_ there.

It took a few seconds, but behind the glassy pericardium the new muscle twitched and then responded, contracting in the first beat of its new life. David's shoulders slumped in relief and he rest his bloody hands on the edge of the table. He felt Vera touch his shoulder in support before mobilizing her team to quickly put Adam back together. Because his sternum was synthetic he wouldn't have nearly the healing time most transplant patients did and it was mere minutes before he was closed up and there was little more than a pink line of nanite rich skin working to heal.

The entire time they were closing him up David didn't take his eyes off his work, unable to help the surge of pride he felt. He knew how uncomfortable the augmentation had made Adam but David hoped that some day soon Adam would be able to see what he saw—that he wasn't losing anything by being augmented. He was designed for it, and the image of his sick heart being replaced was a hopeful one, not the show of desperate last resort Adam seemed to feel it was.

Adam wasn't in nearly as much pain as he'd expected to be in when he woke up. True to her promise, Malik was right at his side, her hand clasping his and a relieved smile lighting her face. "Hey spy boy, welcome back. How do you feel?"

He cleared his throat and grit his teeth as he shifted, trying to decide. "Surprisingly okay..."

"Things went great. You won't even have to stay here for more than two days, then Vera said about a month recovery. They didn't have to split your sternum or anything so it's really just the soft tissue that has to heal."

Adam nodded, feeling quiet and uncertain. He didn't really feel any different than he had from before, though he already noticed that the fatigue was changed. This was a drug induced hazy, not the cold drain he'd dealt with for the last several weeks. Malik rubbed his shoulder with her thumb, brushing across skin and prosthetic in turn.

"What's going through your mind?" she asked gently.

He blinked, unsure for a while, until he realized what was perplexing him so much. "I still have a pulse," he said, looking down at himself with bewilderment. "I can feel it beating. I thought all augmented hearts were turbine based, that they cycled the blood." Truth be told he'd expected to feel far less than human upon waking. Sure he still had flesh parts, but how far off a machine would he really be if even his blood ran quiet inside his veins?

"Yeah, that was one of the issues with the old models," David said, walking into the room and plopping heavily down into the other chair. He looked utterly exhausted, but there was a small smile on his lips. "The turbines wore out too quickly or churned the blood unnaturally and created oxygenation problems. I decided to bypass it all together. Your new heart beats, Adam. It's made of the same muscle fibers your prosthetics are with the added bonus of about ten thousands extra nerve endings so it's responsive down to the millisecond to whatever your nervous system demands. The pericardium has diamond molecules fused with the flex fibers and there's a layer of gel between so there's zero friction. I ran about six hundred simulations and this design turned out the best. I'll have to keep an eye on it, but if my math is right it should keep going for the rest of your natural life."

Adam blinked, realizing he'd been utterly wrong about Sarif's intentions this time. He saw then that this heart was David's penance, his apology for everything. It wasn't a machine's heart at all.

"Thank you, David," Adam said, and the look in Sarif's eyes said he hadn't expected his apology to be accepted. He could see the weight that acceptance took off of David's shoulders.

"It was the least I could do, son."


End file.
